
<link rel="stylesheet" media="screen" href="<?php echo $this->config->item('staticPath').'/'.$this->uri->segment(1); ?>/css/my/style.css" />
<link rel="stylesheet" media="screen" href="<?php echo $this->config->item('staticPath').'/'.$this->uri->segment(1); ?>/css/my/messages.css" />
<link rel="stylesheet" media="screen" href="<?php echo $this->config->item('staticPath').'/'.$this->uri->segment(1); ?>/css/my/forms.css" />
<script type="text/javascript" src="<?php echo $this->config->item('staticPath').'/'.$this->uri->segment(1); ?>/js/jquery.ui.min.js"></script>
 
<div class="container_topmenu">
	<div class="grid_12">
		<div class="grid_3">
			<h5>
			<?php echo $title;?>
			</h5>
		</div>
	</div>
</div>

<div class="container_12" align="center">

	<div class="grid_12">
			<div class="main-content grid_5 alpha">
			<section class="clearfix form">
			 	 <div class="clearfix">
					 
				</div>
			</section>
			</div>	
		<div class="main-content grid_7 alpha">
			<section class="clearfix">
			<form class="form">
				<div class="clearfix">
					<label>English Name <em>*</em><small>Enter school name</small> </label><input
						type="text" name="label_english" required="required" />
				</div>
				<div class="clearfix">
					<label>Thai Name<small>Enter school name</small> </label><input
						type="text" name="label_thai" />
				</div>				
				<div class="clearfix">
					<label>Address 1<em>*</em><small>School address</small> </label><input
						type="text" name="address1" required="required" />
				</div>
				<div class="clearfix">
					<label>Address 2<small>School address</small> </label><input
						type="text" name="address2"  />
				</div>
				<div class="clearfix">
					<label>Telephone 1<em>*</em><small>numeric (max 15 char.)</small>
					</label><input type="text" name="tele1" required="required" maxlength="15" />
				</div>
				<div class="clearfix">
					<label>Telephone 2<small>numeric (max 15 char.)</small>
					</label><input type="text" name="tele2"   maxlength="15" />
				</div>				
				<div class="clearfix">
					<label>Fax <small>numeric (max 15 char.)</small>
					</label><input type="text" name="fax"   maxlength="15" />
				</div>				 
		 
                     <div class="clearfix">
                                    <label>Photo<small>80x80 jpeg/png format</small></label><input type="file" />
                                </div>
				<div class="action clearfix">
					<button class="button button-gray" type="submit">
						<span class="accept"></span>OK
					</button>
					<button class="button button-gray" type="reset">Reset</button>
				</div>
			</form>
			</section>
			</div>

			   <div class="clear"></div>
		</div>
	</div>

	<div class="clear"></div>